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Premenstrual Dysphoric Disorder (PMDD)

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

PMS vs. PMDD - What's the Difference?

Medical Author: Carolyn Janet Crandall, M.D., FACP
Medical Editors: Melissa Conrad Stöppler, MD

Is PMS different from PMS?Ms. B.T. is 38 years old. Her co-workers always seem to know when she has her period. During this time, she becomes extremely irritable. She feels guilty because she gets very angry at her children for no logical reason or for apparently trivial reasons. In fact, one of her coworkers, with whom she is quite friendly, suggested she come in before her supervisor noticed problems on the job. She heard that there is a severe version of PMS that requires special treatment. Ms. B.T. wants to know if this is her problem.

Premenstrual syndrome (PMS) has been the term used for mood, and sometimes physical, symptoms that occur cyclically (predictably in relation to menses) in the second half of the menstrual cycle and interfere with a woman's quality of life. Some women experience even more severe symptoms. These women may have a conditions known as premenstrual dysphoric disorder (PMDD).

What is premenstrual dysphoric disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) can be considered to be a severe form of premenstrual syndrome (PMS). Both PMS and PMDD are characterized by unpleasant physical and psychological symptoms that occur in the second half of a woman's menstrual cycle, most commonly in the days preceding the menstrual period. Fatigue, mood changes, irritability, and abdominal bloating are among the most common symptoms of PMS and PMDD, but numerous other symptoms have been reported. Whereas the symptoms of PMS may be troubling and unpleasant, PMDD may cause severe, debilitating symptoms that interfere with a woman's ability to function.

PMS is much more common than PMDD. PMS may affect to 30% of women with regular menstrual cycles, while only 3% to 8% of these women have true PMDD.

PMDD has been previously medically referred to as late luteal phase dysphoric disorder.

What causes PMDD?

Although the precise cause of PMS and PMDD is unknown, it is believed that these conditions result from the interaction of hormones produced by the ovaries at different stages in the menstrual cycle (such as estrogen and progesterone) with the neurotransmitters (chemicals that serve as messengers) in the brain. While the ovarian hormone levels are normal in women with PMDD, it is likely that the brain's response to these normally-fluctuating hormone levels is abnormal.

Most evidence suggests that PMS and PMDD do not result from any specific personality traits or personality types. While stress clearly is associated with PMS and PMDD, it is not considered to be a cause of PMDD. Rather, the associated stress is more likely to be a result of the symptoms of PMS or PMDD. Vitamin or other nutritional deficiencies have not been shown to cause PMS or PMDD.



Next: What are the symptoms of PMDD? »

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Premenstrual Dysphoric Disorder (PMDD)

What are menstrual cramps?

Menstrual cramps are abdominal and pelvic pains experienced by a woman around the time of her menstrual period. Menstrual cramps usually start shortly before the menstrual period, peak within 24 hours after their onset, and subside after a day or two.

Menstrual cramps can range from mild to severe. Mild menstrual cramps may be barely noticeable and short-lived, sometimes felt just as a sense of light heaviness in the belly. Severe menstrual cramps can be so painful that they interfere with a woman's regular activities for several days. The discomfort can extend to the lower back or legs. Menstrual cramps are not the same as the symptoms experienced due to premenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced together. Many women suffer from both PMS and menstrual cramps.

What is the treatment for common menstrual cramps (primary dysmenorrhea)

Treatment options ...

Read the Menstrual Cramps and Premenstrual Syndrome (PMS) Medication Guide article »











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